Provider Demographics
NPI:1033165600
Name:CARLIN, PATRICIA (M D)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:CARLIN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3564 AVALON PARK BLVD E
Mailing Address - Street 2:STE 241
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7365
Mailing Address - Country:US
Mailing Address - Phone:321-235-0692
Mailing Address - Fax:321-235-0694
Practice Address - Street 1:12301 LAKE UNDERHILL RD
Practice Address - Street 2:STE 215
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4511
Practice Address - Country:US
Practice Address - Phone:321-235-0692
Practice Address - Fax:321-235-0694
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA23037207ZP0101X
FLME148185208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1490555Medicaid
H99362Medicare UPIN
LA1490555Medicaid